Fukuchi Ilana, Morato Meyre Maria Marques, Rodrigues Rubens Ernani Cozeto, Moretti Giovana, Simone Júnior Márcio Falcão, Rapoport Priscila Bogar, Fukuchi Melissa
Medical School, ABC.
Braz J Otorhinolaryngol. 2005 Jul-Aug;71(4):521-5. doi: 10.1016/s1808-8694(15)31210-6. Epub 2005 Dec 15.
Adenoidectomy and/or tonsillectomy are the most frequent surgeries in otorhinolaryngology. Infantile psychological trauma may be caused by surgeries and anesthesia.
To estimate the preoperative service offered to children and their responsible people by examining their psychological profile pre and postoperatively.
Clinical perspective.
We have evaluated the medical chart of children between two and twelve years old who were submitted to adenoidectomy and/or tonsillectomy during February to December of 2003 and analyzed the psychological profile applied to the children and their responsible person.
Out of the total of 78 patients, 32 (41.0%) were in pre-school age and 46 (59.0%) in school age. The predominant feeling in pre-school age was fear (59.4%), while in school-aged children and their responsible guardian it was trust: 63.0% and 48.72%, respectively. As to expectation of surgery results, both children (73.08%) and their responsible people (96.15%) showed optimism. Introverted emotional temperament was observed in the majority of the children (52.56%) and their responsible people (51.28%). The emotional reaction at the immediate postoperative period of children and their guardians was calm: 68.18% and 97.73%, respectively. All children were psychologically apt to be submitted to the surgery.
Independent of the predominant feeling or emotional temperament, good preoperative guidance is required. We have to offer preoperative teaching program that includes verbal descriptions of the procedures among the sensations to be experienced, allied with the interaction of children and parents, looking for reduction of anxiety, response to surgical stress and possible postoperative sequelae.
腺样体切除术和/或扁桃体切除术是耳鼻咽喉科最常见的手术。手术和麻醉可能会给婴幼儿造成心理创伤。
通过检查儿童及其监护人术前和术后的心理状况，评估为他们提供的术前服务。
临床研究。
我们评估了2003年2月至12月期间接受腺样体切除术和/或扁桃体切除术的2至12岁儿童的病历，并分析了应用于儿童及其监护人的心理状况。
在总共78例患者中，32例（41.0%）为学龄前儿童，46例（59.0%）为学龄儿童。学龄前儿童最主要的情绪是恐惧（59.4%），而学龄儿童及其监护人则是信任，分别为63.0%和48.72%。至于对手术结果的期望，儿童（73.08%）及其监护人（96.15%）都表现出乐观态度。大多数儿童（52.56%）及其监护人（51.28%）表现出内向的情绪气质。儿童及其监护人术后即刻的情绪反应平静，分别为68.18%和97.73%。所有儿童在心理上都适合接受手术。
无论主要情绪或情绪气质如何，都需要进行良好的术前指导。我们必须提供术前教育计划，包括对手术过程的口头描述以及将会体验到的感觉，同时结合儿童与家长的互动，以减轻焦虑、应对手术压力及可能的术后后遗症。
